medical-legal

Record Review Sends Med-Legal Costs Soaring

Like a bored multi-billionaire, Medical-Legal expenses for California workers’ comp are needlessly approaching the stratosphere.Our data point to the pri...

CA Med-Legal Reporting Deadline Extension Official

California’s Division of Workers’ Compensation (DWC) has officially extended emergency regulations which add 15 days to the usual time frame for Medical-Legal reporting.<...

Coming Soon: CA Med-Legal Billing Data

There’s only one way to understand, navigate, and improve workers’ compensation: by the numbers.Since the introduction of the new Medical-Legal Fee Schedule (MLFS) in ...

MLFS Billing Tip: CA Med-Legal Deadlines Extended

As providers continue to grapple with COVID-19’s impact on healthcare systems, California Medical-Legal examiners (and workers’ comp claims administrators) are reminded: the ...

Liberty Mutual Stiffs QME - Attorneys Required

Hello California Workers’ Comp Attorneys, Medical-Legal physicians in this state need your help. Payers like Liberty Mutual have found a way to skirt the Independent ...

Med-Legal Reports: Always Include Page Count Verification!

California’s new Medical-Legal Fee Schedule (MLFS), effective from April 2021, brought with it new rules for reporting, billing, and payment. Among those rules: when submitti...

AIG: Improper (but Logical) Med-Legal Underpayment

AIG improperly reduced a California Medical-Legal bill by 88%, providing a dramatic example of how California law incentivizes payers to incorrectly reimburse physicians who ...

Med-Legal Diagnostic Testing Is Reimbursable

FAQ: Is diagnostic testing, as part of a Medical-Legal evaluation, separately reimbursable?A: Yes, as long as the testing is necessary to complete the evaluation.<...

Med-Legal Reports: Always Include Page Count Verification!

Preferred Provider Organization (PPO) and other network discounts do not apply to the Medical-Legal Fee Schedule (MLFS). Period.In other words, the MLFS and OMFS are c...

Med-Legal ML106: IBRs Leave No Doubt

If it wasn’t clear before, it certainly is now. Physicians should bill for supplemental Medical-Legal reports requested before April 1, 2021 with billing code ML106, regardle...

CA Med-Legal: ML200 Missed Appointment Payable

An Independent Bill Review (IBR) case affirmed one of the biggest changes to California’s Medical-Legal Fee Schedule (MLFS): an established reimbursement for missed Medical-L...

Sedgwick Violates LACoFD Employer Contract, IBR Drops Ball

A physician agreed to serve as Independent Medical Examiner (IME) for the Labor Management Committee (LMC) representing the Los Angeles County Fire Department (LACoFD) and Lo...